Knee Ligament Grafts in the BalanceOften in orthopedic surgery, there's more than one way to do an operation. In the case of a tear in the anterior cruciate ligament (ACL), there are two main ways to repair the damage.
In both cases, the doctor uses tendon from some other part of the knee (the graft) to replace the damaged knee ligament. The graft may come from the front of the knee (patellar tendon) or from along the inside of the knee (hamstring tendon).
Does it make a difference which way the surgery is done? Is one method better than another? Only a few studies have compared the two methods. Doctors in a recent study from Finland give us an update. The results of their study show that there is no difference between the two methods.
One hundred patients were divided into two groups. One group had the ACL repair with the patellar tendon graft. The other group received a hamstring tendon graft. Knee function, stability, and results of X-rays were all equal between the two groups. There weren't any differences seen between men and women, either.
There are some other kinds of differences reported between these two methods. The patellar tendon graft is stiffer, perhaps making the knee more stable. However, kneeling commonly causes knee pain in this group. All studies agree that ACL repair should be done as soon as possible after injury. This tends to give the best result overall.
Kim A. Jansson, MD, et al. A Prospective Randomized Study of Patellar Versus Hamstring Tendon Autografts For Anterior Cruciate Ligament Reconstruction. In The American Journal of Sports Medicine. January/February 2003. Vol. 31. No. 1. Pp. 12-18.
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